Hemorrhagic stroke associated with pulmonary edema and catastrophic cardiac failure.
Cerebral arteriovenous fistula (AVF) is a vascular malformation that is rare in the pediatric population. Older children with cerebral AVF tend to present with neurologic problems related to intracranial venous hypertension or intracranial hemorrhage. Cardiac and pulmonary complications following acute neurologic injury such as subarachnoid hemorrhage are common in adults, but are rarely reported in children. However, complications have been reported in cases of enterovirus 71 rhombencephalitis in infants and children and can cause high morbidity and mortality. Here, we report a 14-year-old boy who presented with cardiac failure associated with pulmonary edema following cerebral hemorrhagic stroke due to AVF. After aggressive investigation and management, we intervened before significant hypoxia and hypotension developed, potentially reducing the risk of long-term adverse neurologic consequences in this patient.
Lee
Jiun-Chang
JC
Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Lin
Jainn-Jim
JJ
Lin
Kuang-Lin
KL
Hsia
Shao-Hsuan
SH
Wu
Chang-Teng
CT
Wong
Alex Mun-Ching
AM
D000293:Adolescent; D002543:Cerebral Hemorrhage / Q000150:complications*; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications*; D008297:Male; D011654:Pulmonary Edema / Q000209:etiology*; D020521:Stroke / Q000150:complications*